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April 3, 2010

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A new breed of 'barefoot doctor'

WEARING a straw hat, carrying a small backpack with a simple set of medical equipment and rushing across the rice paddies, the "barefoot doctor" was a common sight in China's rural villages in the 1970s.

But with the improvement of the country's medical system during the past three decades, this kind of doctor, with only about six months of medical training after graduation from secondary school, gradually disappeared despite their great contribution to the health of the nation, offering convenience to the rural sick who were cut off from downtown medical services.

But now they are back. This time, however, they are equipped with advanced medical apparatus and three years of professional training and study on diseases, especially those commonly seen in the countryside.

The first batch of young graduates from the Shanghai Institute of Health Sciences -- a total of 45 students -- have been taking up posts as village doctors since February.

"Having home visits has become my daily routine," says 22-year-old Wang Chunchao, one of the young doctors working in the medical and health care center in Fengjing Town, Jinshan District.

Most of her patients are old people who need special care. "Stomach aches, high blood pressure and diabetes are common diseases among older people, so I need to keep asking them how they feel every time I pay home visits," she says.

The Jinshan native chats with her patients in their local dialect, makes them feel at ease and quickly gains their trust.

"Many hidden diseases are easy to be discovered by chatting with them and that helps them get timely treatment," she says.

Since becoming a village doctor, patients often knock at Wang's door asking her about things such as what to eat and what kind of physical exercises to do.

Once she was woken at midnight by a 77-year-old farmer living in Zhentou Town, who had a serious stomach ache and had been sent by his son to ask for Wang's help.

She jumped out of bed to give him first aid.

"It was diarrhea. I gave him some pills to stop diarrhea and antibacterial drugs to balance the body's electrolytes," she says. The following day Wang took the old man to the senior doctor for further diagnosis and treatment.

"Many old villagers are reluctant to see a doctor when they feel sick, which probably gives enough time for a minor illness to grow into a serious disease," Wang says. "And part of my duty is to push them to have regular physical checks in the nearby hospital or health care center and give them advice on how to take preventive measures."

Village doctors promote basic hygiene, preventive health care and family planning among farmers, cure simple ailments that are common to the area, provide immunizations, delivery for pregnant women and improvement of sanitation. They can refer seriously ill people to township or county hospitals.

Unlike their urban counterparts, village doctors are also trained to deal with the kinds of accidents that often happen in the countryside, such as pesticide poisoning, snakebites, electric shock, wild mushroom poisoning, insect bites and many others.

Other medical skills include feeding pills to infants, cleaning wounds, taking out stitches and attending to new mothers. They also provide sex education for young people.

Statistics reveal that each year millions of college students graduate from medical institutes in Shanghai but few of them choose to be village doctors. Currently Shanghai has about 6 million people living in its suburbs, but only 4,325 doctors working there.

A recent study shows that the average age of these village doctors is 58 with most of them self-taught without too much professional medical education. More than 80 percent of them are secondary school graduates.

Rural villagers are in bad need of their own doctors.

Three years ago, with the approval of the Shanghai Education Commission, the public health authority selected the Shanghai Institute of Health Sciences to launch a three-year course in clinical medicine (village doctor oriented).

The graduates are assigned to the city's eight suburban districts, including Jinshan, Songjiang, Qingpu and others. In the first year 51 high school graduates enrolled and last year the number increased to 150.

Within the next 10 years, Shanghai aims to have 1,500 of the new breed of village doctors who will be able to provide professional medical services for rural residents.

The remote Jinshan District now has eight young village doctors, who are working in the medical stations in six towns.

"Jinshan is an agricultural district with more than 210,000 farmers. Its village clinics have to handle about 1.44 million out-patient attendances each year," says Ni Junjie, director of the district's public health bureau.

"Village doctors are a vital force in the rural medical system, who are working at the frontline to provide medical services to farmers, especially those from poverty-stricken families."

Currently the district has 266 village doctors, with an average age of 51. Some 150 doctors are over 51 and within the next five years, 105 will reach retirement age, according to the public health bureau.

"The first eight young village doctors are the new force and the future of our medical team," the director says.

The eight young doctors are all Jinshan natives. Preferential policies are offered by the local government such as 15,000 yuan (US$2,206) one-off subsidies and free training courses. But they are also required to work as a village doctor for 10 years.

"As a matter of fact, I want to treat my fellow villagers for my entire life. I'm a daughter of farmers," says freshman Zhang Xin from Zhujing Town, who will graduate from the medical school after three years.

"With village doctors, my villagers don't need to queue for hours in the hospital just to get some pills for a cold, worry about the high medical bills, or grope their way in the dark to the hospital if any emergency occurs," she says.


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